Medical Claims
Settlement Services  

It’s likely that one or two claims tell the story behind a group’s loss ratio. All our services are geared to provide that missing financial case management in the form of on-going coordination and communication between the MGU/Carrier, TPA, Case Management, broker and provider to maximize savings. Medical Case Management is half the picture, Financial Case Management is the other half. Our services include:

• In-Network & Out-of-network claims settlement including a signed release.

• Direct, long-term discount agreements for patients with on-going treatment.

• Medical bill review/audit focusing on accurate coding and billing.

• Access to more than 500,000 providers in our National Passive Network. 

• Dialysis and Transplant specialty programs.

• Pharmaceutical reviews for cancer disease management and high-cost injectibles.

• U&C/R&C/UCR Pricing Data.

• Underwriting reviews that help insurers determine financial prognosis. 

• Expert plan document/policy authoring & interpretations.

DON’T SEE SOMETHING YOU NEED? We are always here to help. We frequently add new services and perform numerous special projects for our clients. Call us today to discuss your project and let us explain how we can help.

EthiCare Advisors, Inc.
 Medical Claims Settlement Specialists™
One Maple Avenue - Suite 2G
Netcong, NJ 07857 USA
(888) 838-4422 ext. 3
(866) 662-4121 fax
info@ethicareadvisors.com

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